| NPI | 1619412921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7802) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NV PA1803) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2022-11-01 |